George Bodington 1799-1882
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Dr George Bodington 1799-1882 A Victorian physician ahead of his times Pioneer in treating Tuberculosis Gave humane and positive care to those with Mental Illness Twice Warden of Sutton Coldfield Andrew MacFarlane Chapter One BODINGTON THE PHYSICIAN Introduction Tuberculosis (TB) is one of the worst of all diseases to have afflicted humanity. At least 20% of the English population died after contracting TB in the early Nineteenth Century. Very few sufferers expected anything but a hopeless decline. Although the disease was known from prehistoric times, the accepted medical treatments, developed over many hundreds of years, were harsh, unpleasant and rarely successful. They also weakened the bodily strength needed to resist its advances. (1) George Bodington’s international reputation as a physician is based upon his pioneering treatment of patients suffering from TB (Pulmonary Consumption), described his classic Essay written in 1840. It is unfortunate that medical historians have largely ignored other very significant aspects of his life and work. Typical is a comment by Richard Cyriax, who was a TB Treatment Officer in Warwick and Coventry. In a very well researched and informative article about Bodington’s treatment of TB, Cyriax ended with the comment that “little needs to be said of the remainder of Bodington’s life after 1840.” (2) This statement was quite wrong, but it reflects a commonly held view that Bodington’s later career does not merit investigation. Even his 1882 Obituary gives only a passing reference to his long career caring for mentally ill patients. (3) For thirty years, Bodington worked with compassion and ingenuity, treating patients in his Driffold House Lunatic Asylum. This was a period in history when few physicians had the knowledge or the inclination to specialise in treating mental illness and when there were frequent allegations of profiteering and abuse among owners and managers of asylums. Bodington should also be recognised for his energy and commitment to public service. For more than thirty years, during a time of intense social, economic and political change, he found time to serve as a magistrate and as a leading member of Sutton Coldfield’s historic governing body, the Warden and Society. George Bodington 1799-1882 (Sutton Coldfield Library Archives) 2 Early Life and Education George Bodington was born at Calverton, Bucks in 1799. He came from a large family, closely related to the Warwickshire Bodingtons, who owned considerable landed estates near Kenilworth. (4) He was the seventh of his parents’ eleven children. This possibly explains his decision to take up a profession, rather than competing to manage the family’s rural estates (An older brother also e a GP) became a GP). Calverton Church, Bucks where Bodington was christened Bodington was sent to Magdalen College School, Oxford, one of England’s oldest public schools, dating from 1448. He was almost certainly one of the College’s “pay boys” and not one of the 16 choristers whose education was wholly funded by the School’s foundation. By coincidence, this was also the School which educated John Harman (Bishop Vesey) who was Sutton Coldfield’s greatest benefactor in Tudor times). Magdalen College School in the early 1800s (From R S Stanier: Magdalen School 1958) English public schools were in a general decline at this time, prior to widespread reform later in the Century. There is evidence of some very harsh discipline, as well as occasional violent conflict between the School’s pupils and local youths in Oxford. (5) (None of this seems to have affected Bodington, whose successful career, public service and advanced literary skills indicate that he must have received a very effective education.) In the early 1800s, it was common for aspiring physicians to arrange their own training, usually by seeking practical work experience. They had to work this way because there few structured medical training opportunities. Trainee physicians basically learned by observing and assisting those already in practice. 3 Bodington was first apprenticed at the age of seventeen to Mr Syer, a surgeon in Atherstone, Warwickshire and later to Mr Wheelwright, a City of London surgeon. Bodington’s search medical training led him to St Bartholomew’s Hospital, London, which was not at that time a recognised medical school and did not grant formal qualifications. Like other would-be physicians, Bodington would have paid doctors for allowing him to “walk the wards,” observing them at work and taking opportunities to give practical assistance. Contemporaries wrote of some “casual, episodic and uneven teaching” at St Bartholomew’s, often consisting only of “written compositions, read to students” in crowded halls. These “trainee physicians” did not generally receive enough practical bedside experiences or the necessary degree of structured preparation to meet the demands of general medical practice. (6) However, the evidence of Bodington’s later career suggests that he possessed the motivation, intelligence and curiosity to rise above these serious flaws in medical training. Throughout his career, he showed high degrees of advanced and original thinking, and, according to testimonials from other physicians and the evidence of his own writings, seems to have given individual, competent and thoughtful care to his patients. Bodington gained only one professional qualification before commencing his career in general practice. He was awarded the Licentiate of the College of Apothecaries in 1825. At that time, the numbers of unqualified people practising as physicians causing concern to the government. It thus gave the College powers to “regulate the practice of apothecaries.” It was necessary for physicians to have this minimum qualification since they frequently had to prepare as well as prescribe medicines for their patients. Bodington’s certificate declared that he “had been by us carefully and deliberately examined as to his skills and abilities in the Science and Practice of Medicine and as to his fitness and qualification to practise as an Apothecary.” Copy of Bodington’s Apothecary Certificate (University of Erlangen Archives) He did not obtain his medical doctorate (MD) until 1843 (see below), and was not awarded the Licentiate of the Royal College of Physicians (Edinburgh) until 1859, at 60 years of age. (7) 4 General Practice and Treatment of Tuberculosis “He (Bodington) is an observing and discreet pract itioner … most fully qualified to discharge the difficult duties of his calling with credit to himself and to the satisfaction of the sick and afflicted ….” Testimonial from J T Ingleby MD FRCP (Edin) 13th January 1843 Lecturer at the Royal School of Medicine, Birmingham By 1827, Bodington had established a general practice in Hillaries Road, Erdington and married Ann Fowler, who came from a prosperous local family. The couple set up home nearby at 165 Gravelly Hill. Their first child, George Fowler Bodington, was born in 1829. (8) Even at this early stage in his career, Bodington was keen to publish his views in national medical journals, writing frequently, for example, to the Lancet. He consistently argued that traditional and conventional ways of treating diseases frequently harmed, rather than cured, the patient, because they were too harsh. During an Asiatic cholera epidemic in 1831, he noted that sufferers were being regularly bled with leeches and given medicines based on mercury (calomel). Bodington insisted that they needed to have their resistance strengthened rather than being weakened by the consequent draining of their bodily fluids. By 1839, he was making the same point about scarlatina. He wrote to Lancet claiming to have successfully treated five patients with stimulants and pain relief (“mild anodynes”), instead of what he graphically described as “scouring out” and mercury-based potions. (9) In 1840, George Bodington published his medical Essay, “Bodington on the Treatment and Cure of Pulmonary Consumption.”(10) In later years, this document was been recognised as a classic text in the history of medicine. It described a quite different way of treating patients with TB. Bodington administered a wholesome diet, exercise and a healthy environment (later known as the “fresh air”, or “sanatorium” methods). Bodington also laid out his ideas for specialist treatment centres, which were closely similar to practices that were routine fifty years later and on to the middle years of the Twentieth Century. Despite the praise given by later generations of physicians, the reaction of the medical world to the Essay was overwhelmingly unfavourable and often scathing. Lancet wrote about Bodington’s “very crude ideas and unsupported assertions” and said his suggestions were “far above the range of our limited powers of comprehension.” The reviewer was “at a loss to conceive upon what hitherto unobserved facts Mr Bodington has built up his castle.”(11) His relatively unknown and provincial status as a “country physician” also went against him. He was openly condemning long-accepted treatments that were being used by the most eminent and respected physicians of his day. These included the young Queen Victoria’s own physician, Sir James Clark who took a special interest in TB treatment. One of his patients was the poet Keats, who unfortunately died from TB. (12) Bodington’s Essay was a very bold and confident document. He virtually dismissed any discussion of the “causes, origins and nature” of TB, feeling that these were either fully known or not relevant to treatment. His overriding interest was treating the patient’s symptoms by “natural, rational and successful methods.” (13) Bodington pointed out that “one fifth of the deaths annually in England are from consumption, whilst cures are scarcely ever heard of, and never expected.”(14) He condemned almost all treatment strategies in common use, declaring that these often gave the opposite result to what was intended. Digitalis (extracted from dried foxglove leaves) did not, despite medical claims, regulate the heart and arteries. It was also harmful to use leeches to draw blood, and to administer drugs like calomel and tartarised antimony.